CRS is rare in developed countries with established rubella immunization programs [2-4]. It is no longer endemic in the United States, although a few cases are reported to the National Congenital Rubella Syndrome Registry each year (figure 1A-B) [2,5,6]. These cases typically occur in infants whose mothers emigrated from countries without rubella immunization programs. Following a 15-year initiative involving widespread immunization, rubella was declared in 2015 to have been eliminated from the whole of the Americas region [7].

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